STN STIMULATION--NEURAL CONTROL OF MOVEMENT AND POSTURE

描述(改编自申请者摘要)：高频刺激 丘脑底核(STN)显著改善了所有临床 帕金森病(PD)的运动症状。然而，有有限的 可用于确定哪些运动和运动特征的客观数据 姿势受到STN刺激的影响，以及这是由什么神经机制影响的 完成了。此应用程序的长期目标是获得 客观的神经生理学数据与有效的机制有关 刺激STN改变调节活动的空间和时间模式 人类有计划的运动和姿势。接受STN手术的患者 成功，定义为统一的运动评分降低30% 帕金森氏症评定量表，将参加一系列实验 旨在研究运动和姿势的神经控制。这个 AIM I的实验将使用肌电(EMG)和运动分析 确定力量、运动和站立平衡的哪些方面的技巧 被STN刺激改善、恶化或不变。STN的影响 刺激也将与药物对对照的影响进行比较。 力量和运动的力量。假设是无论是STN刺激还是 药物可使运动控制正常化，而刺激STN则不能 常态化控制站立平衡。AIM 2将使用 脑电(EEG)技术检测STN 刺激引起的运动和步态启动的改变伴随着 反应中大脑皮质活动的时空模式的变化 内部和外部生成的移动线索。假设是 刺激STN不会使正常的通路正常化 受STN的影响，但确实允许其他途径更好地补偿。目标3 将脑电技术与通过四极电极的刺激相结合 植入STN区域，以检测由 有效的STN刺激。拟议中的实验结果将 加深对STN在运动功能中作用的认识，协助 基底神经节在中枢神经系统中作用的改进模型的研究进展 控制运动和姿势，从而有助于改善治疗 治疗帕金森氏症。

DESCRIPTION (Adapted from the Applicant's Abstract): High frequency stimulation of the subthalamic nucleus (STN) dramatically improves all of the clinical motor symptoms of Parkinson's Disease (PD). However, there are limited objective data available to determine which characteristics of movement and posture are affected by STN stimulation, and by what neural mechanisms this is accomplished. The long-term objective of this application is to obtain objective neurophysiological data relating to the mechanisms by which effective STN stimulation alters the spatial and temporal patterns of activity mediating planned movement and posture in humans. Patients in whom STN surgery is successful, as defined by a 30% reduction in the motor score of the Unified Parkinson's Disease Rating Scale, will take part in a series of experiments designed to investigate the neural control of movement and posture. The experiments in Aim I will use electromyographic (EMG) and motion analysis techniques to identify which aspects of strength, movement and standing balance are improved, worsened or unchanged by STN stimulation. The effects of STN stimulation will also be compared with the effects of medication on the control of strength and movement. The hypothesis is that neither STN stimulation nor medication normalizes the control of movement, and STN stimulation does not normalize the control of standing balance. Aim 2 will use electroencephalographic (EEG) techniques to test whether STN stimulation-induced changes in movement and gait initiation are accompanied by changes in the spatial and temporal patterns of cortical activity in response to both internally and externally generated cues to move. The hypothesis is that STN stimulation does not normalize the pathways that are normally influenced by the STN but does allow other pathways to compensate better. Aim 3 will combine EEG techniques with stimulation through the quadripolar electrodes implanted in the region of the STN to examine the pathways activated by effective STN stimulation. The findings of the proposed experiments will advance our understanding of the role of the STN in motor function, assist in the development of improved models of the role of the basal ganglia in the control of movement and posture, and thereby contribute to improved treatments for Parkinson's disease.